LOUDOUN MEDICAL GROUP PC


Address: 224d Cornwall St Nw, Suite 304, Leesburg, VA 20176-2700
Phone: 7037976930

LOUDOUN MEDICAL GROUP PC (NPI# 1043402241) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1043402241
Entity Type Organization
Organization Name LOUDOUN MEDICAL GROUP PC
Other Organization Name ADVANCED EAR NOSE AND THROAT SPECIALISTS
Practice Address 224d Cornwall St Nw
Suite 304
Leesburg
VA 20176-2700
Mailing Address Po Box 17334
Baltimore
MD 21297-1334
Practice Telephone 7037976930
Practice Fax Number 7038585001
Mailing Telephone 7034436717
Mailing Fax Number 7034438643
Enumeration Date 2007-08-13
Last Update Date 2012-09-11
Authorized Official Name MARY BETH TAMASY (CEO)
Authorized Official Telephone 7037376010
Is Organization Subpart Y
Parent Organization Name LOUDOUN MEDICAL GROUP PC

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207Y00000X Otolaryngology Allopathic & Osteopathic Physicians

Other Provider/Organization Names

Other Name Type Code
Advanced Ear Nose and Throat Specialists Doing Business As Name - Organization

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1891217857 Loudoun Medical Group PC Obstetrics & Gynecology 3301 Woodburn Rd Ste 309, Annandale, VA 22003-7308 2017-07-12
1487107587 Loudoun Medical Group PC Specialist 6355 Walker Ln Ste 303, Suite 303, Alexandria, VA 22310-3247 2016-07-26
1184077976 Loudoun Medical Group PC Ophthalmology 1901 N Beauregard St, Suite 100, Alexandria, VA 22311-1738 2016-07-18
1659728889 Loudoun Medical Group PC Urology 24430 Stone Springs Blvd, Suite 100, Dulles, VA 20166-2247 2016-05-18
1285093070 Loudoun Medical Group PC Obstetrics & Gynecology 8292 Old Courthouse Rd, Suite C, Vienna, VA 22182-3834 2016-02-22
1841658499 Loudoun Medical Group PC Internal Medicine 10200 Colvin Run Rd, Suite 326, Great Falls, VA 22066-1830 2016-02-10
1114303922 Loudoun Medical Group PC Surgery 19415 Deerfield Ave Ste 213, Lansdowne, VA 20176-8471 2015-08-04
1285021345 Loudoun Medical Group PC Ophthalmology 8751 Sudley Rd, 2nd Floor, Manassas, VA 20110-8319 2015-04-16
1821409590 Loudoun Medical Group PC Internal Medicine 3687 Fettler Park Dr, Dumfries, VA 22025-2049 2014-05-15
1134530900 Loudoun Medical Group PC Internal Medicine 4897 Prince William Pkwy, Suite C 102, Woodbridge, VA 22192-5432 2014-05-15

Office Location

Street Address 224D CORNWALL ST NW
SUITE 304
City LEESBURG
State VA
Zip Code 20176-2700

Providers in the same location

NPI Name Taxonomy Address Enumeration
1427057686 Michael K Kuo Physical Medicine & Rehabilitation 224d Cornwall St Nw, Suite 202, Leesburg, VA 20176-2700 2005-07-20
1356951651 Medical Center Orthotics and Prosthetics, LLC Prosthetic/Orthotic Supplier 224d Cornwall St Nw, Leesburg, VA 20176-2713 2020-08-03
1104377746 Loudoun Medical Group . P.c Sleep Specialist, PhD 224d Cornwall St Nw, Suite 403, Leesburg, VA 20176-2700 2016-10-19
1194275339 Loudoun Medical Group . P.c Orthopaedic Surgery 224d Cornwall St Nw, Suite 204, Leesburg, VA 20176-2700 2016-10-12
1952851107 Loudoun Medical Group . P.c Internal Medicine 224d Cornwall St Nw, Suite 403, Leesburg, VA 20176-2700 2016-10-12
1679927560 Loudoun Medical Group PC Physical Medicine & Rehabilitation 224d Cornwall St Nw, Suite 403, Leesburg, VA 20176-2700 2016-04-18
1093186587 Nicole Langdon Price Nurse Practitioner 224d Cornwall St Nw, Leesburg, VA 20176-2700 2015-10-09
1609113380 Kristen D Ritch Physician Assistant 224d Cornwall St Nw, Suite 102, Leesburg, VA 20176-2700 2013-01-15
1245586015 Loudoun Medical Group PC Internal Medicine 224d Cornwall St Nw, Suite 303, Leesburg, VA 20176-2700 2012-07-31
1982981924 Loudoun Medical Group PC Orthopaedic Surgery 224d Cornwall St Nw, Suite 204, Leesburg, VA 20176-2700 2011-11-04
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1053912923 Timothy Michael Nixon Pharmacist 61 Catoctin Circle, Leesburg, VA 20176 2020-11-05
1558996645 Stacey E Moran Occupational Therapist 44124 Woodrige Parkway, Lansdowne, VA 20176 2020-03-09
1710531272 Joseph H Kasuska Jr. Specialist/Technologist 19455 Deerfield Ave. Suite 306, Lansdowne, VA 20176 2019-08-01
1568935849 Joel Manalang Polintan Jr. Physical Therapist 171 Cedarwalk Circle, Leesburg, VA 20176 2019-01-09
1194203026 Jing Cao Acupuncturist 19450 Deerfield Ave Ste 275, Leesburg, VA 20176 2018-08-02
1134648314 Alaina Marie Gotwalt Speech-Language Pathologist 43850 Heatherstone Terrace, Unit 406, Leesburg, VA 20176 2017-09-19
1841717105 Happy Inhome Care Corp Respite Care 722 E Market St Ste 103, Leesburg, VA 20176 2017-08-28
1912423484 Aaa Good Healthcare LLC Nursing Care 722 East Market Street Ne, Suite 102, Leesburg, VA 20176 2017-08-16
1740704253 Anna Maria Domingo Seaford Physician Assistant 19441 Golf Vista Plz Ste 230, Lansdowne, VA 20176 2017-07-27
1710436480 Reena Patel Physician Assistant 224 Cornwall St Nw Leesburg Orthope, Unit 204, Leesburg, VA 20176 2016-09-23
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Taxonomy Information

Taxonomy Code 207Y00000X
Grouping Allopathic & Osteopathic Physicians
Classification Otolaryngology

Taxonomy Definition

An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source]
- Additional Resources: American Board of Otolaryngology, 2007. http://www.aboto.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Otolaryngology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1699753442 Mahesh Sarma Parameswaran Otolaryngology 19490 Sandridge Way Ste 230, Leesburg, VA 20176-3467 2006-01-03
1780684399 Dino Madonna Otolaryngology 601 E Dixie Ave, Medical Plaza 901, Leesburg, FL 34748-5953 2005-07-26
1912161977 Roya Azadarmaki Otolaryngology 19450 Deerfield Ave, Suite 400, Leesburg, VA 20176-6820 2008-07-17
1831375294 Loudoun Medical Group PC Otolaryngology 224 D Cornwall Street Nw, Suite 306, Leesburg, VA 20176 2008-01-16
1215051693 Loudoun Medical Group PC Otolaryngology 44035 Riverside Pkwy, Suite 450, Leesburg, VA 20176-8260 2007-03-19
1235253741 Loudoun Medical Group PC Otolaryngology 19465 Deerfield Ave, Suite 301, Leesburg, VA 20176-1701 2007-03-19
1053491704 Elisabeth Ann Fox Otolaryngology 19455 Deerfield Ave, Suite 301, Leesburg, VA 20176 2006-10-17
1568433548 Euclid A Isbell Jr. Otolaryngology 601 E Dixie Ave, Leesburg, FL 34748-5953 2006-01-30
1124028618 Judith Carol Milstead Otolaryngology 601 E Dixie Ave, Medical Plaza 901, Leesburg, FL 34748-5953 2005-07-26
1619977220 Sammy Dwight Vaught Otolaryngology 601 E Dixie Ave, Medical Plaza 901, Leesburg, FL 34748-5953 2005-07-26
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City LEESBURG
Zip Code 20176

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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